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British white paper on public health

Wednesday, November 17, 2004

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ENGLAND — UK Health Secretary John Reid has proposed widespread legislative and health care changes in a new white paper on public health released Tuesday. Titled "Choosing Health", the paper details government plans to restrict smoking in public places, limit 'junk food' advertisements to children, make available "lifestyle trainers", campaign against sexually transmitted diseases and tobacco, and improve food labelling.

The white paper comes after extensive public comment that involved 150,000 people.

Smoking would be restricted in enclosed public spaces, restaurants, workplaces, and some pubs. The ban would be enacted gradually, affecting government and NHS buildings in 2006, enclosed public places in 2007, and private property in 2008. Permanent exemption would be granted to pubs that do not serve prepared food -- though not at the bar -- as well as private clubs, a decision that has provoked some to call the measure incomplete. Up to 90% of pubs are expected to be affected. The Scottish executive proposed a complete ban on smoking in enclosed public places last week, and Ireland has already banned smoking in pubs and restaurants.

Food advertisements targeted to children would be banned until 9pm, under the White Paper's proposals. The restriction is a measure to tackle rising rates of childhood obesity. The government also intends to develop voluntary standards on food and drink advertisements to children with industry, only threatening legislation if an acceptable standard is not reached by 2007. Additionally, low income families would receive vouchers for fresh fruit, vegetables, milk, and infant formula. School lunches would also be held to stricter nutritional standards. Reid has warned that unless childhood obesity is tackled, "we face the prospect of children having shorter life expectancy than their parents".

Food labelling would also be improved, with a "traffic light" system implemented. Packaged food would be evaluated based on its fat, sugar, and salt content.

The paper is unusual for suggesting a more holistic approach to health care, offering for the first time "lifestyle trainers." The National Health Service would be funding with an additional £1bn to make people's overall lives healthier, which is expected to save £30bn in preventable illness.

The paper additionally makes mention of reducing accidents, which affected 2.7m people last year and is a leading cause of child death, curb binge drinking, and reduce substance abuse among youths.

The paper has been criticized by many parties. The Tory Shadow Health Secretary has criticized the Labour government's comprehensiveness and creation of a "new nanny state approach". He has additionally described it as "gimmicks". The Liberal Democrats have accused the government of not being comprehensive enough. It has also been criticized by the British Medical Association as being implemented too slowly, saying "When lives need saving, doctors act immediately".

Mr. Reid has argued against the nanny state label, saying "In a free society, men and women ultimately have the right within the law to choose their own lifestyle, even when it may damage their own health. But people do not have the right to damage the health of others, or to impose an intolerable degree of inconvenience or nuisance on others ... This is a sensible solution which balances the protection of the majority with the personal freedom of the minority in England".

The full white paper "Choosing Health" can be read here.


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